Clinical features

Adults with acute sinusitis usually present with:

• nasal blockage or congestion
• nasal discharge
• dental or facial pain or pressure
• reduction or loss of the sense of smell.
• respiratory symptoms - pharyngeal, laryngeal, or tracheal irritation causing sore throat, change in voice, and cough (1,2).

Children (particularly young children) often present with non‑specific symptoms in the upper respiratory tract. Symptoms of acute sinusitis in children may include the following, but these can be present for many upper respiratory tract infections:

• nasal blockage or congestion
• discoloured nasal discharge
• cough during the day or at night (1,2).

Factors that might make a bacterial cause more likely

• symptoms for more than 10 days
• discoloured or purulent nasal discharge
• severe localised unilateral pain (particularly pain over teeth and jaw)
• fever
• marked deterioration after an initial milder phase (1).

Symptoms of chronic sinusitis are similar to those of acute sinusitis but not as florid (2)

References:

1. National Institute for Health and Care Excellence (NICE) 2017. Sinusitis (acute): antimicrobial prescribing
2. Ah-See KL et al. Management of chronic rhinosinusitis. BMJ. 2012;345:e7054.